Organization
INTENTIONAL LONGEVITY, INC.
Active
Organization
INTENTIONAL LONGEVITY, INC.
Active
Other names
The Center for Spiritual Emergence & Katharos Sanctuary
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRADY BRAXTON JEFFERYS JR. PH.D. (EXECUTIVE DIRECTOR)
(828) 273-1643
Entity
Organization
Contact information
Practice address
370 N LOUISIANA AVE, SUITE D3, ASHEVILLE, NC 28806-3600
(828) 272-1643
Mailing address
370 N LOUISIANA AVE, SUITE D3, ASHEVILLE, NC 28806-3600
(828) 272-1643
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
NC
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NC
Other
Enumeration date
02/18/2016
Last updated
02/18/2016
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